Individual provider Active NPI

John W Carnes, PHD

  • Psychologist
  • St. Petersburg, FL
National Provider Identifier
1790748531
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY3562 Issued in FL
Practice address
2201 Central Avenue
St. Petersburg, FL 33713-8844
Phone
(727) 871-1535
Fax
(727) 824-7133
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY3562 FL Primary

Addresses

Primary practice location

2201 Central Avenue
St. Petersburg, FL 33713-8844

Mailing address

2201 Central Avenue
St. Petersburg, FL 33713-8844
Phone (813) 885-7766

Other identifiers 1

IdentifierTypeStateIssuer
205047100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergent Care Psychologists PA Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1790748531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 CENTRAL AVENUE",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337138844",
            "telephone_number": "813-885-7766",
            "fax_number": "813-889-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 CENTRAL AVENUE",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337138844",
            "telephone_number": "727-871-1535",
            "fax_number": "727-824-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNES",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY3562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205047100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.